Feeding Practices, Lines, and Hospital-Acquired Infection during the Sustenance Phase of Infection Control Quality Improvement

Abstract

Objectives Nosocomial infections are a significant threat to the survival and neurodevelopment of neonates .The present study attempts to correlate enteral feeding practices as measured by nil per oral (NPO days) with bloodstream infection (BSI) rates and central line-associated bloodstream infection (CLABSI) over a period of 2 years and 3 months. Methods This was a prospective observational study done in a tertiary level neonatal intensive care unit (NICU). Data were recorded on the presence of central lines or peripheral intravenous (IV) lines, receipt of intravenous fluids (IVF), total parenteral nutrition (TPN) or IV antibiotics, and mechanical ventilation status. BSI and CLABSI, regarded as sentinel events, were recorded and root cause analysis done. Results A total of 3,448 infants constituting 17,846 patient days with mean gestational age and birth weight of 34.3 ± 3 weeks and 1,868 ± 434 g, respectively were studied. NPO per 1,000 days shows a significant positive correlation with BSI (ρ = 0.513; p = 0.004), CLABSI (ρ = 0.425; p = 0.021), antibiotic days (ρ = 0.7; p < 0.000), IV fluid days (ρ = 0.459; p = 0.014), and central line days (ρ = 0.634; p < 0.001). The IV fluid days showed correlation with BSI (ρ = 0.4, p ≤ 0.03) and CLABSI (ρ = 0.43, p = 0.02). Conclusion BSI in NICU correlates with higher NPO and IV fluid days. Strengthening of enteral feeding practices reduces health care-associated infections.